Copy of Survey of Persons Completing Mediation

Please take a few minutes to complete this survey to help improve the court’s mediation services. Once you have completed the survey please put it in the envelope provided to you and seal it.  Your answers to this survey are confidential.
1.Party Status
2.Representation
3.Please state your agreement or disagreement with the following statements about your experience with mediation.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The mediation was at a time relatively convenient for me.
The mediator treated me with respect.
I did not understand the process that we were to follow.
I learned something new about the other party during the mediation.
I was not well prepared for the mediation process.
I was ablel to do a good job representing my point of view.
The mediatior treated both of us equally.
We were able to put the needs of the children first.
I learned how to negotiate more successfully with the other party.
The mediation process was not fair to me
I did not feel safe during hte mediation session(s)
Overall, I am satisfied with the mediation process
The mediation included new ideas for resolving our disagreement.
I had difficulty participating because an interpreter was not present
I had difficulty participating because of physical barriers
4.What was MOST Helpful about the mediation?
5.What was LEAST Helpful about the mediation?
6.Sex
7.Age
8.Total monthly household income (this includes all income sources including child support) before taxes:
9.Race - Check ALL that apply to you.
10.Are you Spanish/Hispanic/Latino?